In a landmark case report from Mayo Clinic, researchers reveal that a little-understood Islamic practice called Ruqyah—the recitation of Quranic verses—can provide deep metaphysical relief for dying Muslim patients, yet remains largely inaccessible in Western hospitals.
For a 16-year-old girl from Saudi Arabia battling refractory leukemia, the final months of her life were spent not in her homeland, but in a cutting-edge American hospital. Her family had traveled to the United States seeking the best possible medical care: a hematopoietic stem cell transplant. But as her aggressive cancer resisted every novel chemotherapy, the family’s focus shifted from cure to comfort—and to a profound spiritual ritual central to their Islamic faith.
That ritual is called Ruqyah (pronounced rook-yah). It is the act of reciting verses from the Holy Quran and specific prayers over a sick person, seeking healing, protection, and mercy from God. While widely practiced across the Muslim world, Ruqyah is virtually unknown to most Western healthcare providers. And as a new, deeply moving case report published in the journal Palliative and Supportive Care (Cambridge University Press) on April 1, 2025, reveals, this lack of awareness can lead to missed opportunities for culturally sensitive, holistic end-of-life care.
The report, titled “The role of Islamic Ruqyah at end-of-life: An opportunity to provide metaphysical relief,” comes from a team at the prestigious Mayo Clinic in Rochester, Minnesota—one of the world’s leading medical institutions. The authors—Drs. Megan Thorvilon, Asmaa Ferdjallah, and researcher Faduma Warsame—argue that understanding Ruqyah is not a niche cultural curiosity, but an essential component of compassionate palliative care for the growing Muslim population in Western countries.
What is Ruqyah? More Than a Prayer
To understand the significance of this case, one must first understand Ruqyah. It is not magic, nor is it a replacement for medicine. Rather, it is a Quranic-based spiritual intervention rooted in Islamic tradition.
- The Source: The Quran itself declares, “And We send down in the Quran that which is a cure and a mercy for the believers” (Chapter 17, “Al-Isra”).
- The Practice: Ruqyah involves reciting specific verses (such as Al-Fatiha, Ayat-ul-Kursi, and the two protective chapters, Al-Falaq and An-Nas) and supplications (duas) taught by the Prophet Muhammad (peace be upon him). The recitation can be performed by an Imam, a family member, a community member, or even played from an audio recording.
- The Purpose: It is believed to reduce mental anguish, heal physical ailments, and provide protection from spiritual afflictions such as the “evil eye” or psychological distress. At the end of life, Ruqyah serves as a spiritual vigil, reminding the dying person of God’s mercy and the beauty of the hereafter.
In many Muslim-majority countries, Ruqyah is a standardized, respected practice. For example, the report notes that in Saudi Arabia, the Ministry of Health licenses qualified Ruqyah practitioners, who work alongside—not in place of—medical doctors.
The Case: A Family’s Final Hope
The teenage patient at the center of the report was a devout Muslim who expressed a strong desire to practice her faith throughout her treatment. As her condition deteriorated, her family requested Ruqyah from the hospital’s chaplaincy service.
However, the request proved “difficult despite multidisciplinary efforts from chaplaincy, psychology, ethics, and the palliative care team,” the authors write. The medical team was largely unfamiliar with the ritual. When Ruqyah was finally performed, the patient experienced agitation and vomiting—symptoms of her critical illness (bacteremia, neutropenic colitis, and ICU delirium). But her family interpreted these signs differently: as evidence of a spiritual affliction that required continued Ruqyah.
This divergence in perspective is critical. The medical team saw a physical crisis. The family saw a spiritual battle—and they found comfort in fighting it with Quranic recitation. The authors emphasize that, for those practicing Ruqyah, “those practicing Ruqyah are meant to continue recitation especially in the face of restlessness, agitation, and/or emesis.”
The patient ultimately died in the U.S. hospital, never able to return home to Saudi Arabia. Her family was left without the full spiritual support they had sought.
The Core Problem: A Clash of Worldviews
The Mayo Clinic team identifies a fundamental disconnect between Western medical culture and Islamic end-of-life values.
- Misunderstanding Hope: The medical team initially misinterpreted the family’s request for Ruqyah as a form of denial—a refusal to accept that death was near. In reality, the authors explain, for a religious Muslim, hope is a religious duty, but it is a hope placed entirely in God’s will (tawakkul). A Muslim can simultaneously pursue all medical treatments, pray for a miracle, and fully accept that death comes only by God’s permission. Ruqyah at the end of life is not denial; it is an act of surrender and faith.
- The Doctrine of Double Effect vs. Islamic Ethics: Western palliative care often grapples with the “double effect”—the idea that pain relief might unintentionally hasten death. Islam, however, forbids any act that deliberately hastens death. This can create tension when a family requests aggressive treatment until the very last moments, even when medical futility is clear.
- Marginalization of Religious Ritual: Because Ruqyah is unfamiliar, it is often categorized as “complementary or alternative medicine”—placed at the periphery of care. The authors argue this marginalization “minimizes its potential for efficacy.” In fact, previous research (Ghiasi & Keramat, 2018) has shown that listening to Quranic recitation significantly reduces anxiety, even in perioperative settings.
Key Findings from the Mayo Clinic Ruqyah Case Report
| Aspect | Finding | Significance |
|---|---|---|
| Patient Population | 16-year-old Muslim female with refractory leukemia, treated in U.S. | Highlights challenges faced by international Muslim patients in Western systems. |
| Requested Ritual | Islamic Ruqyah (Quranic recitation & prayers for healing) | A common, standardized practice in Muslim countries, but unfamiliar in U.S. hospitals. |
| Provider Response | Difficulty arranging Ruqyah; initial misunderstanding as “denial” of prognosis | Reveals a critical gap in cultural competence and spiritual care access. |
| Family’s Interpretation | Agitation/emesis during Ruqyah = spiritual affliction requiring more recitation | Shows a fundamentally different explanatory model of suffering (spiritual vs. purely biomedical). |
| Outcome | Patient died without full spiritual support; family bereavement potentially affected | Underscores the moral imperative to integrate religious rituals into palliative care. |
| Key Recommendation | Early, active engagement with Muslim Chaplaincy to facilitate Ruqyah | Provides a practical, actionable solution for hospitals. |
Encouraging Data: Why Ruqyah Matters for End-of-Life Care
While the case report is a qualitative study, it cites encouraging quantitative data that every healthcare provider should know.
Supporting Evidence for Ruqyah in Palliative Care
| Study / Source | Data Point | Encouraging Takeaway |
|---|---|---|
| Alshammary et al. (2018) Survey of 200 Muslim cancer patients seeking Ruqyah. | 77% identified “religiosity and spirituality” as their #1 reason. Only 2% sought it due to dissatisfaction with conventional treatment. | Ruqyah is NOT a rejection of medicine. It is a spiritual complement. |
| Ghiasi & Keramat (2018) Systematic review on Quran recitation & anxiety. | Listening to Quran significantly reduces anxiety in perioperative and ICU settings. | Ruqyah has measurable physiological benefits (stress reduction), not just spiritual ones. |
| Islamic tradition (Quran 17:82) | “We send down the Quran as a healing and mercy for the believers.” | For devout Muslims, seeking Ruqyah is an act of faith, not futility. |
| Prophetic teaching (Ibn Majah) | “Make good use of the two cures: honey and the Quran.” | Ruqyah is a Sunnah (tradition of the Prophet), giving it profound religious legitimacy. |
A Path Forward: Building Bridges, Not Barriers
The authors of the Mayo Clinic report do not simply identify a problem; they offer a clear, compassionate path forward for Western hospitals and healthcare workers.
For Hospital Administrators & Chaplaincy Departments:
- Develop institutional guidelines on how to facilitate Ruqyah requests.
- Employ or contract Muslim chaplains who are trained in Islamic end-of-life rituals.
- Create a system to provide recorded Quranic recitation or connect families with local Imams or community Ruqyah practitioners.
For Physicians, Nurses & Palliative Care Teams:
- Ask, don’t assume. During goals-of-care conversations, ask Muslim patients and families: “Would you like for someone to recite Quranic verses or perform Ruqyah as part of your care?”
- Understand the timing. Ruqyah is appropriate at any stage of illness, but it holds special significance at the very end of life as a vigil.
- Reframe your perspective. When a family requests Ruqyah for a dying patient, do not see it as denial. See it as an act of profound hope and love—a family’s final gift to their loved one.
- Collaborate with Chaplaincy. The medical team does not need to perform Ruqyah. They need to enable it by creating a safe, private, respectful space for it to occur.
For Muslim Families & Community Leaders:
- Advocate early. Inform your medical team of your desire for Ruqyah as soon as a serious illness is diagnosed, not just at the very end.
- Bring your own resources if possible. A USB drive with Quranic recitation, contact information for a local Imam, or a family member trained in Ruqyah can be invaluable.
- Educate with kindness. Share articles like this one with your healthcare providers. Most doctors want to help but simply lack knowledge.
The Bigger Picture: Culture, Compassion, and a Good Death
The concept of a “good death” is not universal. For many in the West, a good death might be pain-free, dignified, and surrounded by family. For a devout Muslim, a good death includes something more: the sound of the Quran, the whispered prayers of loved ones, and the spiritual certainty that one is departing this world in a state of remembrance of God.
The Mayo Clinic case report is a powerful reminder that modern medicine, for all its technological wonders, cannot address the deepest human needs at the end of life. Those needs are often not medical—they are spiritual, cultural, and existential.
By failing to understand Ruqyah, the medical team in this case did not act out of malice. They acted out of ignorance. But the result was the same: a family left unsupported, a ritual left unfulfilled, and a young woman who died far from home without the full spiritual embrace of her faith.
As the authors conclude: “Dying is a very challenging stage of life and it is incumbent for the medical provider team to provide support and comfort to the patient and family… We owe it to future patients to support this ritual in hopes of healing and providing culturally sensitive care.”
For the millions of Muslims living in and seeking care in Western nations, this report is a landmark call to action. It is time for hospitals to open their doors—not just to new drugs and devices, but to the ancient, healing power of the Holy Quran.
The evidence is clear: For Muslim patients at the end of life, Ruqyah is not an alternative. For many, it is essential.
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